| Mechanism
of Action: Pravastatin is a competitive inhibitor of 3-hydroxy-3-methylglutaryl
coenzyme A (HMG-CoA) reductase, which is the rate-limiting enzyme involved
in de novo cholesterol synthesis.
Pharmacodynamics/Kinetics:
Onset of action:
several days
Peak effect: 4
weeks
Absorption: poor
Protein binding:
50%
Metabolism: hepatic
to at least two metabolites
Excretion: Urine
Dosage: 40 mg once
daily preferably at bedtime (10 mg in patients with renal or hepatic dysfunction
or receiving immunosuppressants; such as cyclosporine).
Nutrition Considerations:
May be taken without regard to meals. Before initiation of therapy, patients
should be placed on a standard cholesterol-lowering diet (low fat, low
cholesterol) for 6 weeks and the diet should be continued during drug therapy.
Monitoring Parameters:
Obtain baseline LFTs and total cholesterol profile; creatine phosphokinase
due to possibility of myopathy. Repeat LFTs prior to elevation of dose.
Dosage Forms: Tablet:
10 mg, 20 mg, 40 mg, 80 mg.
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